Quiz Question

In Banks 2024 et al., what ostectomy position was associated with the most accurate postoperative TPA?

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Correct. Accuracy in achieving target TPA was best when the ostectomy was placed ≤7.5 mm from patellar tendon origin.
Incorrect. The correct answer is ≤7.5 mm from patellar tendon origin.
Accuracy in achieving target TPA was best when the ostectomy was placed ≤7.5 mm from patellar tendon origin.

🔍 Key Findings Summary

  • Study Design: Retrospective study of 100 radiographs using in silico and clinical data
  • Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
  • Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
  • Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
  • Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
  • Increased distalizationgreater under-correction of TPA (p = .01)
  • Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
  • Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA

Banks

Veterinary Surgery

1

2024

A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

2024-1-VS-banks-5

Article Title: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

Journal: Veterinary Surgery

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In Gutbrod 2024 et al., on feline tibial stabilization, what intramedullary pin diameter was associated with the highest biomechanical performance?

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Correct. Group 2 used a 1.6 mm pin filling ~50% of the tibial canal, yielding superior stiffness.
Incorrect. The correct answer is 1.6 mm (50% fill).
Group 2 used a 1.6 mm pin filling ~50% of the tibial canal, yielding superior stiffness.

🔍 Key Findings

  • 2.4 mm LCP with a 1.6 mm IM pin had the highest axial stiffness and yield strength among the tested constructs.
  • Axial stiffness was significantly higher in the 2.4 mm LCP + 1.6 mm IM pin group compared to 2.7 mm LCP alone (p = .013).
  • No significant difference in torsional stiffness was found among groups.
  • 2.4 mm LCP + 1.0 mm pin had the lowest stiffness and failure load, underperforming both other constructs.
  • All constructs failed via valgus bending, consistent with clinical observations in feline tibial fractures.
  • A 1.6 mm pin (~50% canal fill) resulted in superior construct performance vs. 1.0 mm (~30% fill).
  • Group 2 (2.4 LCP + 1.6 mm pin) outperformed the 2.7 mm LCP alone in stiffness, despite using a smaller plate.
  • Plate–rod constructs may better preserve periosteal blood supply and support minimally invasive stabilization strategies.

Gutbrod

Veterinary Surgery

4

2024

Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

2024-4-VS-gutbrod-3

Article Title: Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

Journal: Veterinary Surgery

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In Cheon 2025 et al., on guide accuracy in DFO, how did correction accuracy compare between uniplanar and biplanar deformities?

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Correct. The study found no significant difference between uniplanar and biplanar correction outcomes.
Incorrect. The correct answer is No significant difference found.
The study found no significant difference between uniplanar and biplanar correction outcomes.

🔍 Key Findings

  • Both patient-specific and universal guides yielded correction errors <2°, with no statistically significant difference in accuracy.
  • Universal guide corrected aLDFA up to 24° and AA up to 20°, addressing multiplanar deformities effectively.
  • Patient-specific guides allowed for preoperative simulation, providing more stable pin placement and potentially aiding less-experienced surgeons.
  • Universal guide eliminated the need for CT-based customization, reducing time and cost.
  • Cadaver and bone model trials showed consistent accuracy, validating both methods in vitro and ex vivo.
  • No significant differences in outcome when correcting uniplanar (aLDFA) vs biplanar (aLDFA + AA) deformities.
  • Universal guide's fixed size presented limitations in small dogs, potentially requiring multiple size options.
  • Universal guide showed potential for standard use, offering repeatable outcomes with minimal prep despite needing precise intraoperative placement.

Cheon

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

2025-3-VCOT-cheon-5

Article Title: Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Gutbrod 2024 et al., on feline tibial stabilization, which construct demonstrated the highest axial stiffness?

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Correct. Group 2 (2.4 mm LCP + 1.6 mm pin) showed the greatest stiffness and yield point under axial loading.
Incorrect. The correct answer is 2.4 mm LCP + 1.6 mm pin.
Group 2 (2.4 mm LCP + 1.6 mm pin) showed the greatest stiffness and yield point under axial loading.

🔍 Key Findings

  • 2.4 mm LCP with a 1.6 mm IM pin had the highest axial stiffness and yield strength among the tested constructs.
  • Axial stiffness was significantly higher in the 2.4 mm LCP + 1.6 mm IM pin group compared to 2.7 mm LCP alone (p = .013).
  • No significant difference in torsional stiffness was found among groups.
  • 2.4 mm LCP + 1.0 mm pin had the lowest stiffness and failure load, underperforming both other constructs.
  • All constructs failed via valgus bending, consistent with clinical observations in feline tibial fractures.
  • A 1.6 mm pin (~50% canal fill) resulted in superior construct performance vs. 1.0 mm (~30% fill).
  • Group 2 (2.4 LCP + 1.6 mm pin) outperformed the 2.7 mm LCP alone in stiffness, despite using a smaller plate.
  • Plate–rod constructs may better preserve periosteal blood supply and support minimally invasive stabilization strategies.

Gutbrod

Veterinary Surgery

4

2024

Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

2024-4-VS-gutbrod-1

Article Title: Ex vivo biomechanical evaluation of 2.4 mm LCP plate rod constructs versus 2.7 mm LCP applied to the feline tibia

Journal: Veterinary Surgery

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In Sadowitz 2023 et al., on screw angle & speed, which insertion method **minimized TCF risk** at a 10° angle?

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Correct. At 10° insertion angle, hand insertion had the lowest TCF rate (3.75%).
Incorrect. The correct answer is Manual hand insertion.
At 10° insertion angle, hand insertion had the lowest TCF rate (3.75%).

🔍 Key Findings

  • TCF risk increased significantly with 10° insertion angle at both 650 rpm (12.5%) and 1350 rpm (17.5%), compared to 0% in the control group (0° at 650 rpm).
  • Hand insertion at 10° angle resulted in only 3.75% TCF rate, suggesting lower insertion speed reduces risk.
  • No TCFs occurred when screws were inserted coaxially (0°) at either 650 or 1350 rpm, indicating angle is a critical factor.
  • Screw speed alone did not increase TCF risk unless combined with off-axis insertion.
  • Radiographically detectable TCFs were only considered; actual rates may be higher with direct bone inspection.
  • Cutting flutes engaging undrilled bone during off-axis insertion likely contribute to TCF formation.
  • Clinical implication: Ensure screws are inserted coaxially and at lower speeds to reduce TCF risk during procedures like TPLO.
  • Statistically significant differences were found between control and high-angle insertion groups: Group C (p = .001), Group E (p < .001).

Sadowitz

Veterinary Surgery

8

2023

Effect of screw insertion angle and speed on the incidence of transcortical fracture development in a canine tibial diaphyseal model

2023-8-VS-sadowitz-4

Article Title: Effect of screw insertion angle and speed on the incidence of transcortical fracture development in a canine tibial diaphyseal model

Journal: Veterinary Surgery

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In Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), what was a key rationale for using neutral wedge osteotomies like PTNWO and mCCWO in dogs with eTPA?

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Correct. Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.
Incorrect. The correct answer is They minimize tibial length change.
Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.

🔍 Key Findings

  • All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
  • Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
  • Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
  • Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
  • Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
  • Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
  • All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
  • Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.

Story

Veterinary Surgery

8

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-8-VS-story-5

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Mazdarani 2025 et al., on simulated muscle loading, what was the clinical significance of using hip mobility in limb press models?

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Correct. Hip mobility improved the physiologic realism of simulated quadriceps forces.
Incorrect. The correct answer is It allowed force ratios closer to in vivo values.
Hip mobility improved the physiologic realism of simulated quadriceps forces.

🔍 Key Findings

  • Simulated quadriceps and gastrocnemius forces increased proportionally with axial load in all three femoral fixation models.
  • Model 2 (rigid fixation) resulted in subphysiologic quadriceps forces and abnormally high gastrocnemius forces, reducing model fidelity.
  • Models 1 and 3 (with hip mobility) produced more physiologic quadriceps and force ratios, especially under 30–40% bodyweight loads.
  • Force ratios were significantly lower in rigid fixation (Model 2) compared to hip-mobile models (p = .007), suggesting model design affects simulated muscle coordination.
  • Joint angles (stifle and hock) remained within acceptable limits, though slight flexion occurred with increasing load.
  • Relative foot position differed by ~3.9 mm between models 2 and 3, with model 2 showing a more caudal position.
  • Model 3 preserved benefits of hip mobility while allowing radiographic documentation, making it a preferred setup for future studies.
  • The study suggests that models used in feline stifle stabilization research may underestimate physiologic forces, especially with rigid fixation designs.

Mazdarani

Veterinary Surgery

5

2025

Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

2025-5-VS-mazdarani-5

Article Title: Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

Journal: Veterinary Surgery

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In Cheon 2025 et al., on guide accuracy in DFO, what correction capacities were designed into the universal guide?

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Correct. The universal guide corrected up to 24° of aLDFA and 20° of anteversion angle.
Incorrect. The correct answer is Up to 24° for aLDFA, 20° for AA.
The universal guide corrected up to 24° of aLDFA and 20° of anteversion angle.

🔍 Key Findings

  • Both patient-specific and universal guides yielded correction errors <2°, with no statistically significant difference in accuracy.
  • Universal guide corrected aLDFA up to 24° and AA up to 20°, addressing multiplanar deformities effectively.
  • Patient-specific guides allowed for preoperative simulation, providing more stable pin placement and potentially aiding less-experienced surgeons.
  • Universal guide eliminated the need for CT-based customization, reducing time and cost.
  • Cadaver and bone model trials showed consistent accuracy, validating both methods in vitro and ex vivo.
  • No significant differences in outcome when correcting uniplanar (aLDFA) vs biplanar (aLDFA + AA) deformities.
  • Universal guide's fixed size presented limitations in small dogs, potentially requiring multiple size options.
  • Universal guide showed potential for standard use, offering repeatable outcomes with minimal prep despite needing precise intraoperative placement.

Cheon

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

2025-3-VCOT-cheon-2

Article Title: Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Sullivan 2025 et al., on TTT stabilization methods, which stabilization method showed significantly different failure force or stiffness?

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Correct. All methods showed comparable failure force and stiffness.
Incorrect. The correct answer is No significant differences were found.
All methods showed comparable failure force and stiffness.

🔍 Key Findings

  • Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
  • All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
  • Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
  • Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
  • No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
  • Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
  • Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
  • Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.

Sullivan

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

2025-3-VCOT-sullivan-1

Article Title: Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Sullivan 2025 et al., on TTT stabilization methods, what biomechanical benefit did the TBW group demonstrate over the others?

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Correct. Only the TBW group had zero crest fractures, unlike the 2-pin and spacer pin groups.
Incorrect. The correct answer is Distal crest fracture prevention.
Only the TBW group had zero crest fractures, unlike the 2-pin and spacer pin groups.

🔍 Key Findings

  • Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
  • All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
  • Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
  • Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
  • No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
  • Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
  • Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
  • Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.

Sullivan

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

2025-3-VCOT-sullivan-3

Article Title: Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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Quiz Results

Topic: Femoral Fixation
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